There is a shortage of both trained healthcare personnel and essential diagnostic equipment in cleft clinics worldwide.


1 in every 700 children around the world are born with cleft lip and/or palate, with an estimated 170,000 babies born with cleft each year in developing countries.

Speech Difficulty

66% of children born with cleft lip and/or palate develop a speech impediment. This is 112,200 children per year.

There are many reasons why children with cleft develop speaking problems, including mislearning, hearing problems, or structural. In many cases, speech therapists working with the patient and family can improve the child’s speech. However, when patient’s speech impediments are caused by structural defects, speech therapy is ineffective because they require further surgery.


An estimated 20% of these children (a total of 33,600 children each year) have a structual defect called VPI which is causing this speech impediment.

The most common ways to diagnose VPI are using a nasoendoscope or a videofluoroscopy.


A medical device called a nasoendoscope is required to diagnose the cause of the speech defects in the child. The nasoendoscope is used to view the nasal passage and pharynx of the patient. Children who visit clinics without nasoendoscopes could spend years in ineffective speech therapy.

We estimate that up to 88% of clinics in developing countries do not have a nasoendoscope, based on data from Smile Train’s partner clinics in 85 countries. Nasoendoscopes are expensive, fragile, and require additional complementary equipment such as bulky light sources and monitors, which make their use difficult in under-resourced clinics. Nasoendoscopes are prohibitively expensive, costing about  $5,000-$15,000 USD per device.

Video source: University of Illinois Hospital and Health Sciences

Copyright 2016 Samantha Olson